HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MfUSST t.;
COM LETED FOR APPLICATION TO BE ACCEPTED
Date: I Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click ari�vi 4t�6 eilyd'84Q'
PROPOSED IMPROVEMENT COCATIQN 3
Address: 10725 S OCEAN DR UNIT 37, JENSEN BEACH, 34957
Legal Description: HOLIDAY OUT AT ST LUCIE BLK A LOT 37 AND EQUAL PRO -RATA INTEREST IN COMMON ELEMENTS (OR 428-2880)
Property Tax ID #: 4511-501-0039-000-1 Lot No.
Site Plan Name: ALABASTER Block No.
Project Name: ALASBASTER
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
WINDOW & DOOR REPLACEMENT ( 11 OPENINGS IMPACT)
Aaaltional worK to De nertormea
HVAC L_J Gas Tank
Electric ❑ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 11,0000.00
unaer tnis permit — ci
[]Gas Piping
❑ Sprinklers
apply:
_ Shutters Z'Windows/Doors
Generator ❑ Roof Roof pitch
SFt. of First Floor:
UtilitiesInSewer 0Septic Building Height:
Name CHARLOTTE ALABASTER
Address: 10725 S OCEAN DR UNIT 37
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax:
Phone No. 623-229-6026
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
vv�y � nnu rvw
Name: MICHAEL GOODWIN
Company: JENSEN BEACH ALUMINUM
Address: 1720 NW FEDERAL HWY
City: STUART State: FL
Zip Code: 34994 Fax: 692-9744
Phone No. 692-0090
E -Mail: MICHAELLGOODWIN@YAHOO.COM
State or County License: CGC 1508437
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: Not Applicable
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
St. Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: You fail to Record a Notice of Commencement may result in y ur yi twice for
improvements tFrk!
our pr er Notice of Commencement must be record n n the jobsite
before t s 'pe,�zE' intend to obtain financing, consult e a 'ney befor
comm c1 r e vour Notice of Commencenle
"v 1.
Signature of Owner/Lessee/Contr or as Agent for Owner ature of Contractor i nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Sr X Z2C_1, COUNTY OF �19/—
The forgoin�gg instrument was acknowledged before me The forgoing instrument was acknowledged before me
ti / Slay of /'�/'�/'�JL 20/Zby the day of 20/ '7' by
(Name of person acknowledging) (Name of person acknowledging )
(Sign at f Notary Pub ic- State o Florida) (Sign atu irotary Pubblic- tate of Florida )
Personally Known __�_ OR Produced Identification Personally Known _, OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Commission No.
AN M. GAUMOND W", ANN M. GAUMOND
MY COt�^,MISSION # FF 173907 '_ '
s+4 :+'= MY COMMISSION N FF 17390
' srhlic Untie wrters ES: December 7, 2018
AP F4, Bonded Thiu Nota: j Pu
Revised 07/15/2014 of {h Bonded Thru Notary Public Underwriters
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